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Female infertility causes  

For a normal pregnancy to occur  a mature egg must be released from ovaries and  this egg must travel through the normal tubes . At the same time,a man’s sperms must travel along the way to fertilise the egg and the fertilized egg must implant inside the uterus. Pregnancy is the result of these steps. Any deviation leads to female infertility.

Female infertility is defined as:

 -failure to conceive within 6months in women above 35 years without any contraception.

 -failure to conceive within 1year in women below 35 years without any contraception.

Female infertility is caused by multiple factors either alone or together.

Commonest Cause is  failure to ovulate:

Achieving pregnancy requires regular menstrual cycles during which an egg is released , a process known as ovulation. The fertilized egg implants and grows in the uterus for a pregnancy to occur. Ovulation disorders account for infertility in 25 percent of infertile couples. These can be caused by  any defect in the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or by problems in the ovary itself.

(1) Failure to produce mature eggs:

In 50% of the cases of anovulation, the ovaries do not produce normal follicles in which the eggs can mature. Polycystic ovary syndrome, the most common disorder responsible for this problem, includes symptoms such as amenorrhoea, hirsutism, anovulation and infertility.

(2) Damage to the Ovaries


Physical damage like extensive, invasive, or multiple surgeries, for  repeated ovarian cysts,infections may cause the capsule of the ovary to become damaged or scarred and impair normal ovulation .

(3) Premature Menopause

This presents a rare cause of anovulation where  some women cease menstruation and begin  menopause before normal age .  It results in depletion of eggs .There is also a genetic possibility for this condition.

(4)  "Unruptured follicle syndrome" occurs in women who produce a normal follicle, but  the egg  remains trapped inside the ovary.

(5) Luteal phase defect  

Luteal phase defect happens when the ovary doesn't produce enough of the hormone progesterone after ovulation  for uterine support.

Tubal factors :

When fallopian tubes become damaged or blocked, they keep sperm from getting to the egg or close off the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include :

- Inflammation of the fallopian tubes (salpingitis)

       - Previous ectopic pregnancy

       - Previous surgery in the abdomen or pelvis

       - Congenital defects in the tubes

- Endometriosis

Uterine causes :

Benign polyps, tumors (fibroids or myomas) in the uterus, an abnormally shaped (bicornuate) uterus, scarred uterus due to any cause can impair fertility by blocking the fallopian tubes or by disrupting implantation .

Cervical stenosis :  can occur because of malformation or damage to the cervix. As a result  cervix can't produce the best type of mucus for sperm mobility and fertilization. In addition, the cervical opening may be closed, preventing any sperm from reaching the egg.

Unexplained infertility :
In some instances , a cause for infertility is never found . It's possible that combinations of minor factors in both partners underlie these unexplained fertility problems. The good news is that couples with unexplained infertility have the highest rates of spontaneous pregnancy of all infertile couples.

RISK FACTORS :

Diet and Exercise

Optimal reproductive functioning requires both proper diet and appropriate levels of exercise. Women who are significantly overweight or underweight may have difficulty in becoming pregnant. 

Smoking

Cigarette smoking has been shown to lower sperm counts in men and increases the risk of miscarriage, premature birth, and low-birth-weight babies for women.  Smoking by either partner reduces the chance of conceiving with each cycle, either naturally or by IVF. 

Alcohol

Alcohol intake greatly increases the risk of birth defects if high level of alcohol is found in  the mother’s blood, may cause Fetal Alcohol Syndrome. 

Drugs

Recreational drug,anabolic steroids,marijuana,cocaine  use should be avoided, both when trying to conceive and when pregnant.

Environmental and Occupational Factors: 

The ability to conceive may be affected by exposure to various toxins in environment. Reproductive toxins like lead ,radiation exposure like x-rays , chemotherapy may cause mutations, birth defects, abortions, infertility or sterility and they have been shown to alter sperm production, as well as contribute to a wide array of ovarian problems.